California State University, Northridge

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

CALIFORNIA STATE UNIVERSITY, NORTHRIDGE

Practice address

18111 Nordhoff St
Northridge, CA 91330-8270

Phone

(818) 677-3666

Fax

(818) 677-5225

NPI assigned

Feb 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Yolanda Reid Chassiakos, M.D.

Title

Director, Student Health Center

Phone

(818) 677-3666

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Klotz Student Health Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1154461580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 NORDHOFF ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913308270",
            "telephone_number": "818-677-3666",
            "fax_number": "818-677-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 NORDHOFF ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913308270",
            "telephone_number": "818-677-3666",
            "fax_number": "818-677-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY, NORTHRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "CHASSIAKOS",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "DIRECTOR, STUDENT HEALTH CENTER",
        "authorized_official_telephone_number": "818-677-3666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER",
            "identifier": "EXE70150F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klotz Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• California State University Northridge
• California State University, Northridge
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• Jazmin Callejas

• Student Health Clinic/Center in Northridge, CA
• Providers in Northridge, CA by specialty
• Student Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.